Survey of rural family physician-obstetricians in Southwestern Ontario.

INTRODUCTION The objectives of this paper are 1) to analyze the characteristics of rural physicians who currently practise obstetrics, their training background and the environment in which they work and 2) to develop strategies to sustain rural obstetrical services. METHODS Information was gathered using both a survey and brief individual interviews. PARTICIPANTS A survey was sent to 56 family physicians who currently practise obstetrics,as well as those who had stopped within the past 2 years, in the Southwestern Ontario communities of Clinton, Goderich, Hanover, Kincardine, Markdale, Mount Forest, Palmerston, Walkerton, Wiarton and Wingham. RESULTS Forty-four physicians responded to the survey. Results indicate that current obstetrical training programs are lacking in the following areas: the provision of positive role models/mentors, rural placements, experience in complex decision-making, and instilling confidence in graduates. Physicians appear to be internally motivated to practise obstetrics, claiming it is important to their professional goals and personal values. Support systems of colleagues, nursing staff, administration, family and friends, were identified as vital components of a successful obstetrical program. CONCLUSION Educators are advised to identify students with an internal motivation to practise rural obstetrics early in their medical training and provide them with mentors, rural placements, confidence and experience in complex decision-making.